Healthcare Provider Details

I. General information

NPI: 1356495063
Provider Name (Legal Business Name): HWA-YING WANG DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAIRE H. Y. WANG DMD

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39201 STATE ST STE 215
FREMONT CA
94538-1437
US

IV. Provider business mailing address

631 LYTTON AVE
PALO ALTO CA
94301-1334
US

V. Phone/Fax

Practice location:
  • Phone: 510-494-9777
  • Fax: 510-494-9724
Mailing address:
  • Phone: 510-299-0017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number38941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: